Development of a diagnostic nomogram for alpha-fetoproteinnegative hepatocellular carcinoma based on serological biomarkers

BACKGROUND Hepatocellular carcinoma(HCC)is the third leading cause of cancer-related death worldwide.Serum biomarkers play an important role in the early diagnosis and prognosis of HCC.Because a certain percentage of HCC patients are negative for alpha-fetoprotein(AFP),the diagnosis of AFP-negative HCC is essential to improve the detection rate of HCC.AIM To establish an effective model for diagnosing AFP-negative HCC based on serum tumour biomarkers.METHODS A total of 180 HCC patients were enrolled in this study.The expression levels of GP73,des-γ-carboxyprothrombin(DCP),CK18-M65,and CK18-M30 were detected by a fully automated chemiluminescence analyser.The variables were selected by logistic regression analysis.Several models were constructed using stepwise backward logistic regression.The performance of the models was compared using the C statistic,integrated discrimination improvement,net reclassification improvement,and calibration curves.The clinical utility of the nomogram was assessed using decision curve analysis(DCA).RESULTS The results showed that the expression levels of GP73,DCP,CK18-M65,and CK18-M30 were significantly greater in AFP-negative HCC patients than in healthy controls(P<0.001).Multivariate logistic regression analysis revealed that GP73,DCP,and CK18-M65 were independent factors for diagnosing AFP-negative HCC.By comparing the diagnostic performance of multiple models,we included GP73 and CK18-M65 as the model variables,and the model had good discrimination ability(area under the curve=0.946)and good goodness of fit.The DCA curves indicated the good clinical utility of the nomogram.CONCLUSION Our study identified GP73 and CK18-M65 as serum biomarkers with certain application value in the diagnosis of AFP-negative HCC.The diagnostic nomogram based on CK18-M65 combined with GP73 demonstrated good performance and effectively identified high-risk groups of patients with HCC.

Morphological characteristics associated with rupture risk of multiple intracranial aneurysms

Objective: To identify the morphological parameters that are related to intracranial aneurysms(IAs) rupture using a case-control model.Methods: A total of 107 patients with multiple IAs and aneurysmal subarachnoid hemorrhage between August 2011 and February 2017 were enrolled in this study.Characteristics of IAs location, shape, neck width, perpendicular height, depth, maximum size, flow angle, parent vessel diameter(PVD), aspect ratio(AR) and size ratio(SR) were evaluated using CT angiography.Multiple logistic regression analysis was used to identify the independent risk factors associated with IAs rupture.Receiver operating characteristic curve analysis was performed on the final model, and the optimal thresholds were obtained.Results: IAs located in the internal carotid artery(ICA) was associated with a negative risk of rupture, whereas AR, SR1(height/PVD) and SR2(depth/PVD) were associated with increased risk of rupture.When SR was calculated differently, the odds ratio values of these factors were also different.The receiver operating characteristic curve showed that AR, SR1 and SR2 had cut-off values of 1.01, 1.48 and 1.40, respectively.SR3(maximum size/PVD) was not associated with IAs rupture.Conclusions: IAs located in the ICA are associated with a negative risk of rupture, while high AR(>1.01), SR1(>1.48) or SR2(>1.40) are risk factors for multiple IAs rupture.

p53、p57联合短串联重复序列基因分型在葡萄胎诊断中的应用

目的探讨p53、p57联合短串联重复序列基因分型在葡萄胎诊断中的应用价值。方法选取2017年3月—2020年3月赣州市妇幼保健院收治的经病理检查确诊的46例完全性葡萄胎患者,34例部分性葡萄胎患者,以及26例水肿性流产患者作为研究对象。获取所有患者的组织标本,采用免疫组织化学法检测p53、p57蛋白表达,采用短串联重复序列基因分型试剂盒进行基因分型检测,采用Kappa一致性检验分析p53、p57联合短串联重复序列基因分型与病理诊断对诊断葡萄胎的一致性。结果完全性葡萄胎绒毛间质明显水肿,且有水池形成,滋养叶细胞明显增生;部分性葡萄胎绒毛间质轻微水肿,可见有水池,滋养细胞包涵体形成,滋养叶细胞轻度或中度增生;水肿性流产绒毛间质轻微水肿,滋养叶细胞增生不明显。完全性葡萄胎中41例p53阳性,阳性率为89.13%;部分性葡萄胎中27例p53阳性,阳性率为79.41%;水肿性流产中3例p53阳性,阳性率为11.54%。完全性葡萄胎中0例p57阳性,阳性率为0.00%;部分性葡萄胎中30例p57阳性,阳性率为88.24%;水肿性流产中26例p57阳性,阳性率为100.00%。41例完全性葡萄胎短串联重复序列基因分型诊断结果与病理诊断相符,符合率为89.13%;31例部分性葡萄胎短串联重复序列基因分型诊断结果与病理诊断相符,符合率为91.18%;25例水肿性流产短串联重复序列基因分型诊断结果与病理诊断相符,符合率为96.15%;所有患者总符合率为91.51%,经Kappa一致性检验,2种诊断方法具有较好的一致性(κ=0.755,P=0.000);44例完全性葡萄胎p53、p57联合短串联重复序列基因分型诊断结果与病理诊断相符,符合率为95.65%;32例部分性葡萄胎p53、p57联合短串联重复序列基因分型诊断结果与病理诊断相符,符合率为94.12%;25例水肿性流产p53、p57联合短串联重复序列基因分型诊断结果与病理诊断相符,符合率为100.00%;所有患者总符合率为96.23%,经Kappa一致性检验,2种诊断方法具有较好的一致性(κ=0.804,P=0.000)。结论p53、p57联合短串联重复序列基因分型用于葡萄胎诊断具有重要价值。

Polarization Jitters Caused by Fiber Nonlinearity in PM Optical Communication System

The phenomenon of polarization jitters caused by fiber nonlinearity is investigated. A general formula about the polarization jitter is concluded in polarization multiplexing (PM) system based on two orthogonal linear polarization states when the best polarization correction is used. A 100 Gb/s PM system based on NRZ code is investigated by simulation, and the Stocks parameter about polarization jitter and Poincare sphere diagrams are got for different power and phase difference of two orthogonal polarized light. The results show that the polarization jitters will be suppressed when the combined PM signal is the linear or circular polarization state.

Inhibition roles of molybdate and borate on Q235 steel corrosion in resistance reducing agent

The effects of Na_(2)MoO_(4) and Na_(2)B_(4)O_(7) on corrosion behavior of Q235 steel in resistance reducing agent(RRA)containing sodium bentonite were studied by mass loss,scanning electron microscopy and electrochemical measurement.The results showed that both the independent and mixed additions of Na_(2)MoO_(4) and/or Na_(2)B_(4)O_(7),can reduce the corrosion rate of Q235 steel in RRA containing sodium bentonite.And the inhibition effect of Na_(2)MoO_(4) and/or Na_(2)B_(4)O_(7)increased with their dosage increase.With the same dosage,the inhibition efficiency of the mixed addition of Na_(2)MoO_(4) and Na_(2)B_(4)O_(7),was higher than that of their independent addition.The passivation effect of Q235 steel was easy to obtain in the RRA with the mixed addition of Na_(2)MoO_(4) and Na_(2)B_(4)O_(7).The optimized inhibitor for the RRA containing sodium bentonite was the mixture of Na_(2)B_(4)O_(7) and Na_(2)MoO_(4) with a total concentration of 1.5 wt.%.Furthermore,the increase in corrosion potential E_(corr) and the decrease in corrosion current density i_(cor) in carbon steel were one of the important criteria for the formation of passivation film.

Hot Corrosion Behavior of SiO_2–Al_2O_3–Glass Composite Coating on Ti–47Al–2Cr–2Nb Alloy: Diffusion Barrier for S and Cl

Type Ⅰ hot corrosion behavior of SiO_2-Al_2O_3-glass composite coating based on Ti-47 Al-2 Cr-2 Nb substrate was investigated in the mixture salt of 25 wt%NaCl + 75 wt%Na_2SO_4 at 850 °C. The results showed that there was a bidirectional ion exchange between composite coating and the film of mixed salts, and the sodium ion in the molten salts penetrated into the glass matrix of composite coating, while the potassium ion in the glass matrix dissolved into the molten salts. A decrease in hot corrosion rate was achieved for the coated alloy in comparison with the bared substrate due to the composite coating acting as a diffusion barrier to sulfur and chlorine and preventing the molten salts from diffusing to the coating/alloy interface during the hot corrosion exposure. Additionally, the composite coating decreased the oxygen partial pressure at the coating/alloy interface and promoted the selective oxidation of Al to form a protective Al_2O_3 layer.